Your Name:

Please Digitally Sign by Entering Your Initials Here:

E-Mail Address:

Cell Phone Number:

Is this your first time booking with Relaxey?

Yes
No

Are you booking a session for TODAY?
Yes
No

If not, what's the date of the session you're interested in:

Time of session:

Duration: One Hour 90 Minutes Two Hours

Is this a couples massage or massage for an individual?
one therapist for one person
two therapists for two people (couples massage)
two therapists for one person (4-hand)

If you are requesting a specific therapist by name please enter the therapist's name here:

All our therapists are competent and among the top in the field. As Health Care Providers, we feel that gender is irrelevant. However, if you have a preference, please let us know. We wish to accommodate you, not impose our worldview.

any gender would be fine
female(s) would be preferred, but not mandatory
Male(s) would be preferred, but not mandatory
female(s) only
male(s) only
one male and one female preferred.
send a Martian; I could care less. If they're a great therapist, it's A-OK.

What is the gender of the person(s) receiving a massage? Female(s) Male(s) Male and Female

What region? NYC NJ CT Hamptons

House Number and Street Name where the session will take place:

Town or City:

Neighborhood or Development:

Type of residence: Private Home Townhouse Condo Multi-Unit Building Hotel

What floor will the session take place on?

What is the apartment or unit number or designation?

If there are special parking procedures, please state here:

Is there an elevator?
No
Yes

If the session is for someone other than yourself, please state the person's name and your connection with them.

Anything else you'd like us to know to be prepared for your session? Include it here!

Would you like to pay now by credit card? Yes No

(Please hit 'Submit' to continue.)

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